Energy expenditure during walking in amputees after disarticulation of the hip. A microprocessor-controlled swing-phase control knee versus a mechanical-controlled stance-phase control knee.

We have compared the energy expenditure during walking in three patients, aged between 51 and 55 years, with unilateral disarticulation of the hip when using the mechanical-controlled stance-phase control knee (Otto Bock 3R15) and the microprocessor-controlled pneumatic swing-phase control knee (Intelligent Prosthesis, IP). All had an endoskeletal hip disarticulation prosthesis with an Otto Bock 7E7 hip and a single-axis foot. The energy expenditure was measured when walking at speeds of 30, 50, and 70 m/min. Two patients showed a decreased uptake of oxygen (energy expenditure per unit time, ml/kg/min) of between 10.3% and 39.6% when using the IP compared with the Otto Bock 3R15 at the same speeds. One did not show any significant difference in the uptake of oxygen at 30 m/min, but at 50 and 70 m/min, a decrease in uptake of between 10.5% and 11.6% was found when using the IP. The use of the IP decreased the energy expenditure of walking in these patients.

[Clinical investigation of serum immunosuppressive acidic protein (IAP) in patients with gastric cancer].

Immunosuppressive acidic protein (IAP) is among the immunosuppressive factors so far detected in the blood of cancer patients. This study was undertaken to determine the blood level of IAP in patients with carcinoma of the gastrointestinal tract, particularly the stomach, and to define the clinical implications of IAP for the therapy. A close correlationship was established between the serum IAP level and the gross degree of malignancy of the tumor and clinical stage of disease, notably in patients with gastric cancer; the serum IAP level was increased with as the disease advanced, the increase being significant in the presence of metastasis or extensive spread of the lesion.

[Concentrations of cefotaxime in serum and myocardial tissue].

Serum and myocardial concentrations of cefotaxime (CTX) were measured in 20 adult patients undergoing cardiac surgery. To all of these patients 1.0 g of CTX was given intravenously (in the range of 13.7--29.0 mg/kg) at the beginning of operation. The serum concentrations of CTX were determined at 5, 10, 30, 60 minutes and 120 minutes after administration. Myocardial concentrations of CTX were also determined at about 30 minutes (group I), 60 minutes (group II) and 120 minutes (group III). The following results were obtained. Average serum CTX concentrations were 132.8 +/- 34.1 micrograms/ml at 5 minutes, 92.0 +/- 23.1 micrograms/ml at 10 minutes, 44.6 +/- 12.3 micrograms/ml at 30 minutes, 24.5 +/- 7.7 micrograms/ml at 60 minutes and 12.3 +/- 4.9 micrograms/ml at 120 minutes after administration. Average myocardial CTX concentrations were 10.0 +/- 3.7 micrograms/g in group I, 3.6 +/- 2.1 micrograms/g in group II and 2.3 +/- 1.8 micrograms/g in group III. The myocardial/serum concentration ratio was 0.22 +/- 0.14 in group I, 0.15 +/- 0.08 in group II and 0.18 +/- 0.12 in group III, respectively. These results suggested that the serum and myocardial concentrations of CTX were high enough to be prophylactic and therapeutic against not only aerobic but also anaerobic and opportunistic infections during and after cardiac surgery.

[Clinical studies of serum protease inhibitors in hepatoma].

The hemorrhagic disposition of patients with hepatic cirrhosis and hepatoma may be associated with DIC. Thus, elucidation of the role of coagulation and fibrinolysis inhibition factors as hemostatic mechanisms in living organisms and in the growth or metastasis of neoplasms is important. Therefore, we measured the levels of serum protease inhibitor and plasminogen in hepatoma patients and compared them with those of patients with other hepatic diseases. Hepatoma was found to induce a marked increase in the alpha 1 AT, alpha 1X and C1 INA levels and a marked decreased in the I alpha I and Pmg levels. The alpha 2 M and AT III levels showed a wide distribution; no significant difference was observed between the hepatoma group and the normal control group. However, hepatoma patients with the DIC syndrome showed a marked decrease in their AT III, Pmg, alpha 2M and I alpha I levels and an increase in their alpha 1 AT and alpha 1X levels. Moreover, the serum protease inhibitor levels corresponded closely with the clinical course.